Fifty years ago, ensuring access to family planning services, especially for low-income Americans, was a priority for a Republican president.
“I am confident that by working together — at Federal, State, and local levels — we can achieve the goal of providing adequate family planning services within the next 5 years to all those who want them but cannot afford them,” President Richard Nixon said in a signing statement accompanying the Family Planning Services and Population Research Act of 1970.
Five decades later, the Trump administration has greatly weakened the federal family planning program, known as Title X, by restricting information that providers can share with their patients.
Because of the new rules, Maine Family Planning and Planned Parenthood have dropped out of the federal family planning program. Dropping out of Title X has cost the Maine groups a significant source of their funding, putting at risk a wide range of family planning services that are especially important to the state’s low-income residents. Nearly 23,000 Mainers receive services through 50 clinics and health centers that were supported by the Title X grant.
A bill, LD 1613, sponsored by House Speaker Sara Gideon, would replace the lost federal funds with state money, at a cost of $2 million per year.
Title X provides funding for family planning, such as contraception and treatment of sexually transmitted diseases, along with preventative treatments including screenings for breast and cervical cancer. Nearly two-thirds of those who receive services under Title X have incomes at or below the poverty level. For many, it is the only health care they receive, according to an annual report by the U.S. Department of Health and Human Services.
Last year, the department changed its rules, making it more difficult for Title X patients to access the full spectrum of services offered at participating clinics. The so-called gag rule makes it illegal for health care providers in the Title X program to refer patients for an abortion and limits what information can be shared about ending a pregnancy. These providers are already banned from using federal funds for abortion services.
Censoring these providers inhibits the patient-provider relationship and compromises medical ethics by prohibiting providers from providing patients information about all of their options.
The federal Department of Health and Human Services began enforcing this provision in July.
The rule changes also requires “physical separation” between areas where abortions are provided and areas where other health care services are provided. This could require separate entrances and staff members, which could be cost prohibitive for some providers, especially small, rural health centers. Following the new rules would also have meant compromising standards of care, which the Maine grantees were willing to do.
Elsewhere in the country, patients are already having to pay much more for family planning services and for health screenings. Some clinics have reduced their hours because of the new rules.
Maine Family Planning challenged the legal validity of the rule change. That court challenge and two others elsewhere in the country are ongoing.
Efforts in Congress to reverse the rules stalled after the House included funding for Title X and language repealing the gag rule in its appropriations package, but the Senate did not.
To keep the full spectrum of Title X family planning and preventative health care available to all who need them in Maine, state lawmakers should approve this funding until the federal money is restored.